Staged Laparoscopic Adjuvant Intraperitoneal Chemohyperthermia (ipch) After Complete Resection for Locally Advanced Colorectal or Gastric Cancer

Purpose: Cytoreductive surgery followed by intraperitoneal chemohyperthermia (IPCH) is a promising treatment for patients with peritoneal malignancies. Usually, IPCH is performed concomitantly with cytoreductive surgery for peritoneal cancinomatosis (PC) or more occasionally as an adjuvant treatment after gastric resection for cancer. In this report, we describe our experience with staged adjuvant laparoscopic IPCH after complete resection in patients with advanced colorectal or gastric cancer.
Methods: 25 patients underwent resection for colorectal (16 patients) or gastric cancer (9 patients) followed by staged laparoscopic IPCH. Operative technique, complications, as well as more than 2-year follow-up findings were assessed.
Results: Mean intraperitonel temperature was 41.9° C. The homogeneity of the hyperthermia across the abdominal cavity was electronically maintained throughout the procedure by input and output flow regulation. No conversion to laparotomy was performed. No major operative incident was encountered.
The mean hospital stay was 11 days (6-24). No 30-day mortality occurred. Five patients developed complications (20 %). One patient was reoperated (4 %).
Mean follow-up was 30.5 months (24-49). Six patients died including 4 of cancer related causes (distant metastases). 17 patients (68 %) had some form of second look laparoscopy or laparotomy and 4 patients had autopsy (16 %). All patients had PET scans every 6 months. No patient developed PC.
Conclusion: Staged laparoscopic adjuvant IPCH after open or laparoscopic resection in selected patients with colorectal or gastric cancer is safe and feasible. After more than 2-year follow-up, no patient seemed to have developed PC. Additional survival data are still needed.

Session: Podium Presentation

Program Number: S088

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